Even the most basic physical movements often involve the use of one’s ankles. So experiencing an injury in this area can cause a notable level of disruption in a person’s daily activities. Learning more about it and how to treat a sprained ankle can help hasten one’s recovery and assist a person in getting back on their feet as quickly as possible.

Mechanism of Injury

It’s not uncommon for patients to report a sprained ankle resulting from a seemingly benign movement such as stepping off a curb in a pair of high heels.

However, most ankle sprains occur after a person engages in a sudden, unnatural movement such as slipping on a patch of ice or tripping on an obstacle in their path. An ankle sprain can also occur after trauma to the ankle area. This includes a fall from a motorcycle or bicycle. Playing contact sports or simple overuse can also result in a sprained ankle. Overuse injuries are often experienced by professional sports figures, gymnasts, or people in training for a triathlon.

Ankle Anatomy

The ankle area is a complex region comprised of many ligaments and muscles. These allow for a wide range of motion, a high degree of flexibility, and strength to support the rest of the body. Ligaments, in particular, provide stabilization for the ankle joint and help to prevent excess movement. The outside of the ankle consists of a ligament complex made up of three separate ligaments, the anterior talofibular ligament, the posterior talofibular ligament, and the calcaneofibular ligament.

A sprain in this complex is referred to as a lateral ankle sprain. This is the most common type of sprain to affect the ankle region. There are also ligaments that support the inner ankle (the deltoid ligament), as well as a host of others that form connections between parts of the ankle and the bones in the lower legs and each foot. Any one of these ligaments (as well as nearby muscles) can stretch or tear after a twisting, rolling, or turning motion. Movements that force one or more of these supporting structures beyond a normal ROM (range of motion).

Types of Sprains

Ankle sprains are typically divided into three separate categories. These categories include:

  • Grade 1 — A person with this level of injury will experience some pain, along with mild swelling and tenderness due to stretching or slight tearing of a ligament. The ankle is still stable so the injured can walk, albeit more slowly and carefully.
  • Grade 2 — Tearing is still incomplete. However, the injured person experiences a higher level of pain, along with moderate swelling, tenderness, and bruising. Although the ankle still feels somewhat stable, walking is notably more difficult.
  • Grade 3 — At this level, an injured person will experience a significant swelling ankle sprain. It is accompanied by severe pain and bruising from a complete ligament(s) tear. The torn ligament leaves their ankle in an unstable mode. This greatly increases the chance their ankle will “give out” if they attempt to walk.

Treatment and Rate of Recovery for a Sprained Ankle

Treatment for a minor (grade 1) sprained ankle is usually successful with the RICE method (rest, ice, compression, and elevation). In fact, most people recover within one to three weeks. A moderate sprain (grade 2) usually takes about three or four weeks for recovery. It also often requires treatment beyond the RICE method in the form of a splint or immobilization device. A severe grade 3 sprained ankle can take longer than four weeks for recovery. Without proper treatment, this level of an ankle sprain can turn into a permanent injury.

Depending upon the severity of the injury, as well as a patient’s age and other co-morbidities, a physician may decide to send their patient to a series of physical therapy treatments. After an evaluation, a physical therapist’s first task is to reduce the pain and swelling around the injured region. To accomplish this, they may employ methods such as retrograde massage and/or laser treatments. After reducing swelling and tenderness, the therapist then begins to work on increasing the patient’s range of motion in and around the injured area, with the introduction of gentle stretching exercises.

The Bottom Line

Eventually, the physical therapist will introduce additional exercises designed to strengthen ankle components and surrounding areas. They will also introduce other exercises that will help improve a patient’s balance and proprioception. Whether their patient is a “weekend warrior” or if they engage in professional sports, a physical therapist’s ultimate goal is to return their patient to their prior level of function.

Would you like to know more about how physical therapy can help resolve issues with a sprained ankle? Please contact Cawley Physical Therapy & Rehab at 570-208-2787.